Adult Dosing
Human immunodeficiency virus type 1 (HIV-1) (All doses with food)
Treatment-Naive w/o Ritonovir
Treatment-Naive w/ Ritonovir
- 300 mg PO daily
- Info: give w/ ritonavir 100 mg PO qd; give w/ food
Treatment-Experienced
- 300 mg PO daily in combination with ritonavir 100 mg PO daily
Pediatric Dosing
Human immunodeficiency virus type 1 (HIV-1) (All doses with food)
Treatment-Naive
- (
6 yrs and 15-25 kg): 150 mg PO daily with ritonavir 80 mg PO daily - (6 yrs and 25-32 kg): 200 mg PO daily with ritonavir 100 mg PO daily
- (6 yrs and 32-39 kg): 250 mg PO daily with ritonavir 100 mg PO daily
- (6-17 yrs and 39 kg): 300 mg PO daily with ritonavir 100 mg PO daily
- (13 yrs and 39 kg and intolerant to ritonavir): 400 mg PO daily
Treatment-Experienced
- (6 yrs and 25-32 kg): 200 mg PO daily with ritonavir 100 mg PO daily
- (6 yrs and 32-39 kg): 250 mg PO daily with ritonavir 100 mg PO daily
- (6 yrs and >39 kg): 300 mg PO daily with ritonavir 100 mg PO daily
[Outline]
Renal Dose Adjustment
Therapy-naive adults
- Mild-severe renal impairment: No dose adjustments
- HD:300 mg PO daily with ritonavir 100 mg PO daily; administer with food
Therapy-experienced adults
- Mild-severe renal impairment: No dose adjustments
- Hemodialysis: Contraindicated
Child
- Renal impairment: Dose adjustments not defined
Hepatic Dose Adjustment
- Mild hepatic impairment: Use with caution
- Moderate hepatic impairment (Child-Pugh Class B) who have not experienced prior virologic failure: reduce dose to 300 mg PO daily; administer with food
- Severe hepatic impairment (Child-Pugh Class C): Contraindicated
- Avoid concomitant use with indinavir as potentially life-threatening adverse events, significant drug interactions, or loss of virologic activity has occurred.
- Prolongs PR interval of the electrocardiogram. Abnormalities in atrioventricular (AV) conduction are asymptomatic and generally limited to first-degree AV block
- When used in combination with diltiazem consider reduction of dosages of diltiazem to one half and ECG monitoring
- Mild-moderate maculopapular skin eruptions have occurred. Discontinue therapy on occurrence of rash. Cases of Stevens-Johnson syndrome, erythema multiforme, and toxic skin eruptions have occurred
- Asymptomatic elevations in indirect (unconjugated) bilirubin related to inhibition of UDP-glucuronosyl transferase (UGT) have occurred; it is reversible upon discontinuation
- Evaluate hepatic transaminase elevations that occur with hyperbilirubinemia for alternative etiologies
- Long-term safety data is not established for patients experiencing persistent elevations in total bilirubin >5 times ULN
- Consider alternative antiretroviral therapy to atazanavir if jaundice or scleral icterus associated with bilirubin elevations presents cosmetic concerns for patients
- Dose reduction is not recommended as long-term efficacy of reduced doses has not been established
- Patients with underlying hepatitis B or C viral infections or marked elevations in transaminases before treatment are at increased risk for developing further transaminase elevations or hepatic decompensation; conduct appropriate laboratory tests prior to initiating therapy and monitor these patients during treatment
- On occurrence of signs or symptoms of nephrolithiasis or cholelithiasis consider temporary interruption or discontinuation of therapy
- New-onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, and hyperglycemia have occurred during postmarketing in HIV-infected patients receiving protease inhibitor therapy
- Immune reconstitution syndrome and redistribution/accumulation of body fat have occurred
- Increased bleeding, including spontaneous skin hematomas and hemarthrosis have occurred in patients with hemophilia type A and B treated with protease inhibitors
- Monitor LFTs at baseline, then q3-4 months or more frequently if history of HBV and HCV
- After starting new regimen monitor fasting blood glucose at 1-3 months thereafter at least q3-6 months
Cautions: Use cautiously in:
- Hepatic impairment
- Preexisting conduction system disease
- Administering with other drugs that prolongs the PR interval
- Concomitant use with drugs metabolized by CYP3A
- HBV infection
- HCV infection
- Hemophilia
- Diabetes mellitus
- Cardiac conduction disturbances
Pregnancy Category:B
Breastfeeding: HIV-infected mothers should generally not breastfeed their infants. In countries in which no acceptable, feasible, sustainable and safe replacement feeding is available, exclusive breastfeeding for 6 months is recommended for HIV-infected mothers to reduce the risk of HIV transmission from the mother to the infant compared with mixed feeding. In these settings, abrupt weaning at 4 months does not reduce the risk of HIV transmission or produce an overall health benefit compared to continued breastfeeding, and increases the risk of infant death in HIV-infected infants. Extended antiretroviral prophylaxis in breastfed infants with antiretroviral reduces the rate of HIV transmission during breastfeeding by about half, but the optimal regimen and duration of prophylaxis has not yet been defined. Prefer an alternative drug especially while nursing a newborn or preterm infant as adequate literature on breastfeeding is unavailable. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5 January 2011). Centers for disease control and prevention recommends avoiding mothers breast-feeding their infants as risk for postnatal transmission of HIV-1 infection exists .Unknown whether atazanavir is excreted in human milk. Manufacturer advises to instruct infected mothers to avoid breast-feeding during therapy because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants.
Pricing data from www.DrugStore.com in U.S.A.
- Reyataz 200 MG CAPS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
60 mg = $1064.94
180 mg = $3105.92 - Reyataz 150 MG CAPS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $557.97
90 mg = $1616.92 - Reyataz 300 MG CAPS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $1067.99
90 mg = $3155.91
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
